A report of disseminated adenocarcinoma presenting as thrombotic thrombocytopenic purpura

Thrombotic microangiopathies (TMAs) represent a heterogeneous group of diseases characterized by a microangiopathic hemolytic anemia, peripheral thrombocytopenia, and organ failure of variable severity. TMAs encompass thrombotic thrombocytopenic purpura (TTP), typically characterized by fever, central nervous system manifestations and hemolytic uremic syndrome (HUS), in which renal failure is the prominent abnormality. In patients with cancer TMAs may be related to various antineoplastic drugs or to the malignant disease itself. The reported series of patients with TMAs directly related to cancer are usually heterogeneous, retrospective, and encompass patients with hematologic malignancies with solid tumors or receiving chemotherapy, each of which may have distinct presentations and pathophysiological mechanisms. Patients with disseminated malignancy who present with microangiopathic hemolytic anemia and thrombocytopenia may be misdiagnosed as thrombotic thrombocytopenic purpura (TTP) Only a few cases of TTP secondary to metastatic adenocarcinoma are known in the literature. We present a case of a 34-year-old man with TTP syndrome secondary to metastatic small-bowel adenocarcinoma. Patients with disseminated malignancy had a longer duration of symptoms, more frequent presence of respiratory symptoms, higher lactate dehydrogenase levels, and more often failed to respond to plasma exchange treatment. A search for systemic malignancy, including a bone marrow biopsy, is appropriate when patients with TTP have atypical clinical features or fail to respond to plasma exchange

Be careful what you eat and drink; Coprinic and Kounis syndrome in a patient with the Samter`s triad

Allergic reactions to chemicals, food products or even insect bites are encountered all over the world with a variety of manifestations. Symptoms range from the development of a minor rash to life threatening anaphylactic reactions. Sometimes, acute coronary syndrome (ACS) can be registered in such patients, which may have a serious impact on the course and management of the allergic reaction. Mushroom poisoning constitutes the main portion of plant toxicities in Spain. Depending on the type of mushroom, the adverse effects range from mild gastrointestinal (GI) symptoms to major cytotoxic effects resulting in organ failure and death. Coprinopsis atramentaria poisoning is rare but with serious consequences. We report a case of a 27 year old patient with a previous history of mild persistent asthma, nasal polyps and aspirin allergy that arrived to the Emergency Department with dizziness and temor after consuming beer at a party. On arrival to the hospital, the patient suddenly collapsed, with an electrocardiogram (ECG) showing ST elevation in the inferior leads and 3rd degree atrioventricular (AV) block accompanied by urticarial-like lesions. After administration of treatment, the patient and ECG abnormalities improved. A detailed medical history showed that the patient had eaten scrambled mushrooms and beer. Expert analysis demonstrated that the combined consumption of Coprinopsis atramentaria and alcoholic beverages produced a disulfiram-like reaction (Coprinic syndrome) and type I Kounis syndrome. No case like this has been previously reported

Mundos de vida entre los jóvenes de Medellín : identidad, espacio y medios masivos

RESUMEN: el aporte de este libro se encuentra en el entendimiento de los jóvenes y sus grupos desde sus propios términos, acercándonos a sus mundos de vida y a sus ejercicios comunicativos. ¿Cómo construyen, actúan y narran sus identidades? ¿Qué propuestas culturales son fundamentales dentro de sus mundos de vida? Buscamos un acercamiento a los escenarios de los diferentes jóvenes que cohabitan la ciudad, que comparten día y noche los espacios físicos y simbólicos, en muchos casos, sin un conocimiento profundo del otro, si no guiados por una serie de estereotipos, prejuicios y estigmas. De igual manera, revisamos la mirada y representación que se tiene de ellos desde afuera, desde el mundo adulto. Siguiendo el anterior orden de ideas nos cuestionamos ¿Cómo los ven los medios masivos de comunicación?, ¿Cuál puede ser su aporte en la solución de las problemáticas de violencia de la cuidad y el país?, ¿Qué nuevos oficios están aprendiendo y desarrollando?, ¿Cómo se apropian del espacio para su subsistencia?, ¿Cuáles son los espacios de distinción de clase social?, ¿Qué músicas escuchan, bailan, viven?, ¿Qué respuestas políticas desarrollan frente a la discriminación y el estigma? Entender estos espacios juveniles, estas identidades, captar cómo se relacionan entre ellos y con el resto de la sociedad es realizar un mapeo y una prospectiva social. Es darse cuenta de qué se está nutriendo una nueva generación de antioqueños urbanos y de colombianos. Saber cómo se piensan y cómo piensan a los demás es entender a quienes pronto harán el relevo social y marcarán nuevas sendas.CONTENIDO: Introducción.-- Parte I. Panorama juvenil.-- 1. Panorámica de los mundos de vida de los jóvenes en Medellín y el AMVA.-- Parte II. La espacialidad de los jóvenes.-- 2. Identidades emergentes en la trama cuerpo-territorio.-- 3. ¿Cómo se vive un espacio cuando cambia? Aproximaciones a las formas de apropiación del espacio público por parte de jóvenes en el parque de El Poblado (Medellín, Colombia).-- 4. Jóvenes de clase alta de Medellín. Espacialidad, distinción, consumos, interacción y discriminación.-- Parte III. Jóvenes, medios y culturas juveniles.-- 5. La juventud en encuadre. El cine, la televisión y la ciudad.-- 6. Pasado y presente de las culturas juveniles en la escena roquera de Medellín: punk, metal y pospunk.-- 7. Juventud y baile: problematización de los roles de género a partir de la producción de espacios de posibilidad.-- Parte IV. Nuevos escenarios juveniles.-- 8. El mundo de los jóvenes consumidores de marihuana.-- 9. Los jóvenes y el posconflicto.-- 10. Una aproximación al oficio de cocinero desde una perspectiva joven en Medellín o por qué estudiar cocina en la ciudad.-- Índice analítico

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

Advancements in dementia research, diagnostics and care in Latin America : highlights from the 2023 Alzheimer's association international conference satellite symposium in Mexico City

While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics and care. In 2023, the Alzheimer’s Association hosted its eighth Satellite Symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. A wide range of topics were covered, including epidemiology, social determinants, dementia national plans, risk reduction, genetics, biomarkers, biobanks, and advancements in treatments. Large initiatives in the region including intra-country support showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care and implement affordable biomarkers in the region was highlighted

Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Motivar el aprendizaje autónomo de la lengua extranjera: Inglés y fortalecer las cuatro habilidades comunicativas de los estudiantes del grado noveno 2 de la Institución Educativa Enrique Olaya Herrera, ubicada en el distrito especial de ciencia, tecnología e Innovación de Medellín, a través de la implementación de un objeto virtual de aprendizaje.

Este proyecto tiene como objeto mejorar los niveles de motivación en el aprendizaje de la lengua extranjera inglés y el fortalecimiento de las cuatro habilidades comunicativas: listening, speaking, reading and writing en los estudiantes del grado 9°2 de la institución educativa Enrique Olaya Herrera, a través de la implementación de un objeto virtual de aprendizaje llamado “Learning English at home 9°grade” creado en la plataforma Google Sites, partiendo de las necesidades e intereses que los estudiantes manifestaron en la etapa inicial de la investigación.En general, el análisis de datos arrojó que los estudiantes sienten mayor motivación al momento de aprender la lengua extranjera cuando se emplean recursos que son afines a sus gustos, como la música y juegos.MaestríaMagíster en Recursos Digitales Aplicados a la Educació